A Prospective Study of Comparison of Cervical Ripening with Oral vs Vaginal Misoprostol in Nulliparous Women

Kim, Kyung Koo; Chun, Kyung Chul; Choi, Hyung Min

Abstract

OBJECTIVE
To compare the safety and efficacy of oral misoprostol, vaginal misoprostol, and oxytocin-only users for cervix ripening and labor induction in nulliparous women.
METHODS
Randomly selected 11 patients were orally administered 50 microgram of misoprostol at first and then 100 microgram every 4 hours and the other 9 patients were vaginally administered 25 microgram of misoprostol at first after then the same doses every 4 hours. They all were nulliparous women with Bishop score 6 or less. Another 19 patients were oxytocin only users for cervical ripening and labor induction, who were nulliparous women with Bishop score 6 or less, and reviewed these medical records retrospectively.
RESULTS
There were no differences among these three groups in patient characteristics such as maternal age, gestational age, parity and initial Bishop score. In oral misoprostol group, it took shorter time to get Bishop score 8 or more and become effacement 60% or more than vaginal misoprostol group. On the contrary, in vaginal misoprostol group, it took shorter time to become full dilatation and deliver than oral misoprostol group. However there were no significant statistical differences between two groups in obstetric and neonatal outcomes.
CONCLUSION
Oral and vaginal misoprostol are effective in cervical ripening but there were no significant statistical differences in perinatal outcomes. Among many regimens of misoprostol administration for cervix ripening in nulliparous women, there is no standardized method until now. More studies will be needed for safe application of this drug.